Survival to age 85 was more common in northern Spain, northeastern Italy and southern France, for example, than in areas of northern Europe and Scandinavia, researchers found.

Old-age survival is easier to measure in small areas than actual life expectancy, said lead author Ana Isabel Ribeiro of the Instituto de Engenharia Biomedica-INEB at the Universidade do Porto in Portugal.

"In high income countries, life expectancy is increasing because older people live longer, whereas in the past the increase in life expectancy was mostly driven by the fall in premature mortality," Ribeiro told Reuters Health by email.

For the study, the researchers used longevity data from more than 4,000 small areas of 18 European countries. Specifically, they looked at the 10-year survival rate of people age 75 to 84 according to a census year. The researchers calculated these 10-year rates twice, once for 1991 to 2001 and once for 2001 to 2011.

For the whole study area, by 2011, almost half of the women who were 75 to 84 years old in the 2001 census were still alive, having reached age 85 to 94, compared to 34 percent of men. Both survival rates had increased from the previous 10 years.

But those numbers differed by country.

For women and men, there were lower survival rates in industrial areas of the U.K. including London, mining areas of France, and parts of Denmark and The Netherlands.

Northern Spain, western and southern France, and northeastern Italy had higher than average survival rates in 2001 and 2011, the authors reported in the Journal of Epidemiology and Community Health.

In the U.K., the Essex area had the highest old-age survival rate, about 40 percent of men in 2011, whereas Liverpool, Manchester and Glasgow ranked among the areas in Europe with the lowest old-age survival, about 27 percent.

There was a more than 2.2-fold difference between European areas in terms of old-age survival, Ribeiro said.

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"If we had included, for instance, eastern European countries the gap would be even wider," she said.

Biological and behavioral factors, like genetics or diet, physical environment factors like pollution, and healthcare, political and socioeconomic systems may all play a role in the differences in old-age survival, but the study was not designed to test those theories, she said.

Socioeconomic factors might explain a big part of the observed differences, as areas of high and low Gross Domestic Product in Europe seem to match closely with areas of high and low survival, she said.

"Life expectancies in European countries are among the highest in the world," including some southern European countries and Scandinavian countries, said Colin Mathers, a senior scientist at the World Health Organization who was not part of the new study.

But within the same continent and country not all places and populations have the same opportunities, Ribeiro said.

"As a Portuguese, I am concerned that Portugal has a much lower old-age survival rate than our 'neighbor' Spain, despite the cultural and economic features they share," she said.

In general, older age mortality will be dominated by cardiovascular, diabetes and cancer deaths, and death rates at older ages reflect accumulated risks in younger years, like smoking, diet, exercise and obesity, Mathers told Reuters Health by email.

SOURCE: http://bit.ly/1QEAtnf Journal of Epidemiology and Community Health, online February 15, 2016.